Electrocardiography (ECG), or the recordation and analysis of the electrical potential of a patient's heart, is one of the most widely used patient physiological monitoring techniques used in healthcare today. In ECG the electrical potentials of various regions of the heart are monitored through the use of electrodes to obtain data that is indicative of the systematic depolarization and repolarization of the heat muscle tissue. Interpretation of this physiological data can be used to identify many cardiac conditions including, but not limited to, bradycardia, tachycardia, ischemia, arrhythmia, myocardial infarction, and drug toxicity. An ECG signal comprises more than the mere collection of biopotentials. Rather, an ECG signal comprises a differential measurement, referred to as a lead, that measures the voltage across the heart between a reference location and a measurement location. Each of the resulting differential leads are denoted by a reference to the physical location of the electrode on the patient used in obtaining that lead.
In a typical 12-lead ECG measurement, ten electrodes are used to obtain the twelve leads. These electrodes include the standard electrode placements at the right arm (RA), left arm (LA), left leg (LL), and right leg (RL). These standard electrodes are supplemented by the addition of six precordial electrodes that are placed at specific locations around the patient's chest and are denoted by the indications V1, V2, V3, V4, V5, and V6.
One major problem with obtaining ECG measurements is that ten separate wires each corresponding to one of the ten electrodes attached to the patient must be used in order to obtain a 12 lead ECG as just described. This can cause a host of problems associated with obtaining ECG measurements. First, the lead wires may restrict physician access to the patient. This limitation on the physician's access to the patient may include the reduced ability of a physician to inspect patient wounds or other anatomical parts due to the large number of lead wires obscuring access. Furthermore, the large number of wire extending from the patient may limit the ability of the physician to attach additional electrodes and lead wires that extend to other patient physiological data monitors, thus impairing the ability to monitor other important physiological parameters of the patient. Furthermore, if a patient requires defibrillation, the electrodes and lead wires must be removed from the patient to prevent damage to the equipment or additional harm to the patient. The more electrodes and lead wires extending from those electrodes, the more difficult it is to quickly and accurately remove all of these connections.
The presently available systems are further undesirable because the large number of lead wires extending from the patient further restricts the patient's movement. The large number of lead wires may restrict where the patient may place his/her arms and/or where and how he/she moves about a hospital bed or room. For example, when a patient is sleeping, the lead wires may restrict the positions in the hospital bed in which the patient may sleep, thus leading to an uncomfortable nights sleep and slower recovery.
Alternatively, due to patient movement or clinician movement about the patient, the lead wires may become tangled. Tangling of the lead wires may lead to electrode and/or lead wire damage. Electrode or lead wire damage results in inaccurate physiological data, resulting in reduced physician ability to diagnose the patient's condition. Furthermore, tangled lead wires may require additional clinician time in removing, untangling, and replacing the tangled electrodes and lead wires with new connections. Additionally, a large number of lead wires may result in the lead wires become tangled while they are in storage and as such, a clinician must spend time before the initial application of the electrodes to untangle the lead wires. The propensity of the lead wires to become tangled also increases the chances of damage to the lead wires. In many instances, if a single lead wire becomes damaged or broken, the entire lead wire set must be replaced at additional cost because the lead wires are individually associated with a specific ECG lead anatomical location.
Attempts have been made to address these and other similar problems, resulting in solutions such as those taught by Schoeckert et al. U.S. Pat. No. 5,546,950 and Kornrumpf et al. U.S. Pat. No. 6,415,169. Solutions such as those presented in the aforementioned patents are summarized with respect to FIG. 1, which depicts an electrode set for obtaining physiological data from a variety of locations on the patient's body.
FIG. 1 depicts an electrode set 10 including a plurality of electrodes 12. Each of the electrodes 12 is connected to an individual lead wire 14. To reduce the tangling of the lead wires 14, all of the lead wires are connected together in the form of an amalgamated lead wire 16. Each of the lead wires 14 extend off of the amalgamated lead wire 16 to provide a limited range of movement within which the clinician can place the electrode 12. The amalgamated lead wire 16 terminates at one end in a plug 18 that comprises a plurality of individual pins (not depicted), each pin associated with one of the lead wires 14 and electrodes 12. When the plug 18 is inserted into a monitoring device (not depicted) the monitoring device associates a specific pin location in the plug 18 with a particular ECG lead to be monitored. To obtain a proper ECG measurement each lead 14 and electrode 12 must be connected to a correct anatomical location on the patient. The proper anatomical placement of the electrode 12 and lead wires 14 may be facilitated by the labeling, or color coding of the lead wires 14 or electrodes 12, such that the clinician may be informed of the proper lead wire 14 and electrode 12 that must be connected to the proper anatomical location. However, due to clinician error, one or more of the lead wires 14 may be connected to an electrode 12 that is located at the improper anatomical position.
Additionally, in the electrode set 10 depicted in FIG. 1, the amalgamated lead wire 16 comprises, or may comprise, a large number of wires. Each additional wire in the amalgamated wire 16 renders the amalgamated lead wires 16 more inflexible, thus decreasing the ability to maneuver the wire, and the patient's overall mobility. Furthermore, in an electrode set 10 comprising an amalgamated lead wire 16 if a single lead wire 14 becomes damaged, the entire amalgamated cable 16 is rendered useless because the ECG lead that the monitoring device associates with the damaged lead wire 14 cannot be measured using that lead set 10. Therefore the entire amalgamated cable 16 must be replaced at added cost.
Therefore, a need exists for an electrode set that limits the number of wires extending from a patient to a data monitor. Furthermore, a need exists for an apparatus and method of using an electrode set that reduces tangling of electrode set lead wires. Additionally it is desirable for an apparatus and method for an electrode set that reduces error in the collection of data due to the connection of a lead wire to an electrode located at an improper anatomical location. Finally, it is desirable for an apparatus and method for an electrode set that may still be used to obtain a full twelve lead ECG measurement despite damage to at least one lead wire.